When I'm on the night shift, all the department heads can't sleep.

"The anesthesiology department will not start a procedure without at least eight units of suspended red blood cells!"

Outside operating room number nine, the second-line attending anesthesiologist stood with a cold, hard expression, his hands in his white coat pockets, his tone leaving no room for negotiation:

"Blood pressure is 55, heart rate is 120, and blood clotting function has collapsed."

"If we start induction of general anesthesia now, the peripheral vascular resistance will drop, and the patient will suffer cardiac arrest on the operating table within thirty seconds. The anesthesiology department cannot gamble with your lives without a blood supply!"

"Are we just going to watch him die in the red zone?!" The deputy director of orthopedics was so anxious that the veins on his forehead bulged.

"Alright, stop arguing!"

Qin Hai walked out of another emergency room, his white coat still stained with iodine and blood from the thoracentesis he had performed on the bus passengers.

"The blood transfusion department's blood supply for today was completely depleted by the three patients with pelvic fractures and ruptured livers and spleens who were brought in earlier."

"The emergency blood delivery vehicle from the central blood bank is stuck in traffic on the cross-river bridge during the morning rush hour, and it will take at least 40 minutes before it can reach the hospital."

Forty minutes.

For this wounded patient suffering from hemorrhagic shock and severe crush syndrome, even four minutes could be a matter of life and death.

Just as everyone's attention was completely focused on the "eight units of blood," and the arguing nearly shook the emergency room to its core—

A countdown appeared at the edge of Lin Ye's line of sight.

【09: 42】

【09: 41】

Less than ten minutes until death!

Everyone in the hospital had their eyes on the empty refrigerator in the blood bank, and on the coagulation function test report. Even the anesthesiologist thought the patient was just anemic!

Lin Ye reached out and put his arm around the driver's arm.

It was icy to the touch, even with a chilling dampness and stiffness.

His gaze suddenly swept to the IV stand by the bed, on which hung three bags of room temperature saline solution that had just been injected during the emergency treatment, without even a warming cover.

The injured person was exposed to the cold draft of the tunnel for half an hour. The severe trauma and blood loss took away a lot of heat, and in order to quickly expand the volume, the emergency room continuously injected unwarmed room temperature crystalloid solution!

body temperature!

The activity of thrombin in the human body drops by half when the body temperature is below 35 degrees Celsius, and it stops completely once the temperature drops below 34 degrees Celsius!

Even if the blood bank is emptied now, as long as the patient's body temperature doesn't rise, the blood poured in will just be a stagnant pool that can't clot!

This is the real dead end of the countdown rapidly reaching zero!

"Fang Rui! Immediately shut down all unheated regular IV lines!"

Lin Ye suddenly shouted, his voice so loud that it instantly drowned out the argument between Qin Hai and the anesthesiologist.

Everyone in the emergency room was stunned and turned to look at him.

"Teacher Lin?" Fang Rui was holding a bag of lactated Ringer's solution, preparing to inject it under pressure, when he was yelled at and his hand froze.

Lin Ye didn't waste any words. He strode to the bedside, grabbed the temperature probe, and inserted it directly into the driver's rectal temperature measurement port.

Three seconds later, the deep body temperature reading popped up on the monitor screen.

34.2℃!

The anesthesiologist's second-line pupils suddenly contracted.

"Did you see that?"

Lin Ye stared directly at the anesthesiologist.

"Everyone is searching for blood, but the core problem now isn't just a lack of red blood cells, but rather the traumatic triad of hypothermia!"

"His current internal environment is such that the activity of his clotting factors is paralyzed. Even if we empty the blood bank and fill it with blood, the thrombin won't work, and the wound will bleed like a waterfall until he dies!"

Qin Hai reacted instantly.

"Damn it! We've all been distracted by the massive hemorrhage! This kid's been lying in that freezing tunnel for way too long!"

The countdown in my sight continued relentlessly: [07 minutes 18 seconds...]

"Sister Zhao, turn the air conditioning in the red zone up to the highest temperature of 30 degrees Celsius! Bring out two heated blankets and wrap the patient completely, except for the wounds!"

"Both rapid-heating infusion machines are set to their maximum temperature of 42 degrees Celsius. Crystalloid and colloid solutions must pass through the heating channel before entering the bloodstream!"

"Fang Rui, administer two grams of tranexamic acid intravenously to inhibit fibrinolysis. Immediately administer three grams of fibrinogen dissolved in warm saline via the internal jugular vein to forcibly patch up the blood!"

Two thick, inflatable heating blankets were instantly placed over the driver's gaunt body, and scalding hot air rushed in, while the liquid in the heated infusion machine flowed rapidly through the 42-degree tubing.

Under extreme rewarming efforts, the body temperature at the head of the bed began to climb with great difficulty from 34.2℃.

34.4℃……34.7℃……

But even though the body temperature rose, the blood was still empty.

Shock compensation had reached its final limit, and blood pressure dropped again to 50/30 mmHg.

Qin Hai took out his phone, his fingers quickly swiping across the screen, and dialed the hospital's emergency blood allocation hotline:

"Hello! This is Qin Hai from the Emergency Department! Immediately activate the Level 1 Emergency Response Plan for Mass Traumatic Blood Transfusion at the First Municipal Hospital!"

Qin Hai roared into the receiver:

"Notify the Obstetrics and Gynecology Department and the Cardiothoracic Surgery Department! The Obstetrics and Gynecology Department has two elective cesarean sections scheduled today, and has prepared four units of type O red blood cells before the surgeries; the Cardiothoracic Surgery Department has prepared four units of the same type of red blood cells for the bypass surgery this afternoon!"

"These two elective surgeries are postponed, and the blood reserves have been urgently requisitioned with special approval from the hospital's on-call supervisor. All of it will be allocated to the emergency room's first bed! Anyone who dares to obstruct the procedures, tell them to come directly to the emergency room and find me, Qin Hai!!"

After hanging up the phone, Qin Hai abruptly turned to look at Ma Hao:

"Ma Hao! Take a special refrigerated transport box, two people, and run to the obstetrics and gynecology department and the thoracic surgery department to beg for blood! Get me some!"

"yes!"

Ma Hao grabbed the red transfer box, and with two male nurses, rushed out of the emergency room like a cannonball, heading straight for the inpatient elevator!

In the emergency room, time was locked in a brutal tug-of-war.

Lin Ye stared intently at the monitor, then at the countdown timer at the edge of his vision:

【03: 22】

【03: 21】

With the continuous perfusion of the heated blanket and the radiant warmer, the body temperature at the bedside finally climbed with difficulty to 35.5 degrees Celsius, and the activity of thrombin was quietly recovering. Norepinephrine was infused, and the mean arterial pressure was stubbornly held at 58 mmHg.

"Bang!!"

Ma Hao slammed the automatic sensor door of the emergency room open with his shoulder!

Ma Hao was panting heavily, as if he had been pulled out of the water. He clutched the cooler, which was heated with dry ice, and slammed it hard onto the treatment table.

"Director Qin! Lin Ye! We've borrowed them! All four units of Obstetrics and Gynecology, and all four units of Cardiothoracic Surgery, are here!!"

Eight bags of dark red, cold-precipitated, suspended red blood cells, carrying life-saving nutrients transferred from multiple departments across the hospital, were placed on the emergency vehicle!

"Dual-channel pressurized rapid warming blood transfusion!"

Lin Ye let out a long breath and turned to look at the second-line attending anesthesiologist who was standing at the door, completely stunned:

"Temperature 35.6, eight units of blood prepared, fibrinogen and hemostatic drugs fully administered!"

Lin Ye grabbed the handrail of the transfer bed.

"Dr. Li, now, do you dare to start the show?"

The second-line anesthesiologist took a deep breath, abruptly ripped off his gloves, and the hesitation in his eyes completely transformed into a desperate, all-or-nothing resolve:

"Move into operating room number nine! Anesthesiology department, take over!!"